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A Guide To Workers Compensation Insurance

When workers offer their services to their employer, there is the possibility that they could sustain injuries while at the workplace. In some cases, these injuries are severe and medical bills or even funeral expenses have to be covered. Statutes have been developed to create a framework through which medical and rehabilitation costs of the injured employee can be covered. As a result, the complexities of a lawsuit are eliminated since the employee gives up their right to sue the company for negligence. Moreover, employees can recover from their injuries in peace.

What is workers’ compensation?

Workers’ compensation is an insurance program mandated by the state. The insurance program is designed to compensate employees if they suffer work-related illnesses or injuries. The insurance covers medical and rehabilitation expenses and in some cases could cover the lost wages of the injured employee.

Employees who sustain job-related injuries or illnesses can get the benefits related to workers’ compensation regardless of who was at fault. This could have been the employee, a coworker, the employer, a customer or some other third party. Having this kind of insurance cover usually, means that employees give up their right to sue their employer in a court of law for negligence.

How to get workers compensation?

For a worker to be eligible for workers’ compensation benefits, they must meet the following eligibility criteria:

  • The employer who had enlisted the labor of the worker must be a holder of workers’ compensation insurance or must have been required by law to carry such insurance.
  • The worker must be a recognized employee of the person or company
  • The injury or illness suffered by the worker must have been work-related.

How much does workers compensation cost?

Since the states regulate workers’ compensation programs, the costs of the insurance cover differ significantly from one state to another. Moreover, the cost of workers’ compensation insurance varies depending on the location of the business as well as the industry in which it operates. The rates will also be influenced by the nature of duties and responsibilities assigned to the worker. Lastly, if one has been in business for a reasonable period, whether their workers’ compensation rates will go up or down will depend on their accident history.

Who pays workers compensation?

Workers’ compensation is paid for in full by the employer. No payroll deductions are made on the paychecks of individual employees.

Although the structure of workers’ compensation insurance differs from state to state, employers pay for the insurance program in one of three ways. The employer will submit premiums to a state-run insurance scheme which makes payments to a private insurance company or pay the benefits directly to their workers. Regardless of the plan adopted by an employer, the benefits to be paid to workers will remain the same.

What does workers compensation cover?

Workers’ compensation cover covers expenses in four major categories:

  • Medical treatment – the medical care benefits will cover costs related to surgeries, hospital stays, visits to the doctor, treatment, medications and medical equipment. For the treatment to be paid for, it has to be reasonable and necessary as well as be related to the injury sustained in the course of duty.
  • Wage replacement – if the work-related injury keeps the affected employee away from work, the employee will be entitled to wage replacement benefits. This will depend on whether they fall into one of the specified types of disabilities. In most cases, employees will be paid around two-thirds of their initial wages. Moreover, such employees will not be required to pay income tax on their earnings.
  • Vocational rehabilitation – these benefits are designed to cover costs associated with therapeutic care. Such physical therapy is usually aimed at ensuring that the affected employee makes a full recovery and that they can be trained to get back to work or assume different positions.
  • Death benefits – in case the injury or illness is fatal, the family or beneficiaries of the deceased will receive some benefits. The benefits include funeral and burial expenses as well as financial support. The financial support to be received will be calculated as a percentage of the deceased employee’s earnings.

How long can you be on workers compensation?

The length of time that a worker can be on workers’ compensation differs from one state to another. For temporary benefits for an injury, most states limit the length of time that workers can receive the benefits. The limits are usually in the neighborhood of three to seven years. When it comes to permanent disability benefits, there is usually no time limit. However, some states will terminate the weekly benefits once the employee reaches the age of 65.

What are the most common non-fatal injuries?

In most cases, employers will be required to record cases of injuries away from those of illnesses. In this regard, the most common non-fatal injuries at the workplace include sprains, strains, fractures and cuts.

Frequently asked questions

Are all disabilities covered under workers’ compensation law?

Not all disabilities are covered under the law. The only disabilities that can be compensated are those that are related to accidental injury and are sustained in the course of employment. Also, disability related to work-related disease will also be compensated.

What are the responsibilities of the employer before an injury occurs?

Before any work-related injury occurs, an employer is expected to secure workers’ compensation insurance for the employees. Alternatively, the employer should qualify to be self-insured. Moreover, whenever the employer recruits new employees, they should provide all the new employees with a pamphlet that explains their rights and responsibilities. Lastly, the workers’ compensation poster should be placed in locations where all the employees can access and see it.

Can I choose my doctor?

Yes. You are at liberty to choose a physician of your choice. However, if you are severely hurt or unconscious and your employer chooses a doctor for you, you are still free to choose a physician after you have been released. Once you choose your preferred physician, you cannot change the physician until you get approval from your employer’s insurer or the office of worker’s compensation.

Traditionally, when workers sustained injuries in the workplace, they never had resources to sue their employers in a court of law. In cases where the employees sued the employer, they ended up losing the case. This is because it was assumed that they understood the risks related to the job when they took it up. Today, many things have changed. Workers’ compensation has made it possible for employees to enjoy numerous benefits I the event that they suffer injuries or illnesses at the workplace or in the course of duty.

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